Health Related Quality of Life in Patients with Diabetes Mellitys Type I

Diabetes mellitus type I (DMT1 I is a chronic disease caused by the autoimmune destruction of the insulin-producing beta cells in the pancreas, resulting in an absolute inability to produce the hormone insulin which is necessary for the regulation of blood glucose levels. The autoimmune destruction is postulated to result from an interaction between genetic and environmental factors, with the latter triggering the onset of the disease in genetically susceptible individuals. Various theories explaining the pathogenesis have been proposed in which environmental agents may serve as modifiers of pathogenesis rather than as triggers. These environmental risk determinants may be classified into three groups: viral infections, early postnatal diet, and toxins. Other non-genetic disease modifying factors include vaccine administration, psychological stressors, and climatic influences. The incidence of DMT1 is rapidly increasing in many parts of the developed world, and is showing a trend toward earlier age of onset. The incidence of DMT1 is highly variable among different ethnic populations, occurring most frequently in persons of north European descent, diminishing in southern direction, the 'North-South gradient', with the notable exception of Sardinia. The incidence of DMT1 is projected to be approximately 40 percent higher in 2010 than it was in 1997. The prevalence in The Netherlands is 0.3 percent. Diabetes mellitus type I is characterized by hyperglycemia with the eventual development of micro- and macrovascular complications which define the degree of morbidity in these patients

General practice registration networks in the Netherlands: a brief report

In the Netherlands, several general practice registrations exist. Groups of general practitioners register elements of patient care according to agreed-upon criteria, and these data are collected in a central database. By means of a questionnaire the authors interviewed the managers of all nine computerized registration networks extensively about the possibilities and limitations of their registration. In addition, respondents answered some questions with data from the central database of their network. Various items are collected by nearly all the registration networks, while other items are collected by only one network. Answering questions with data from the central database turned out to be difficult. Organization and manpower are the main obstacles